Include MEAT in Your Risk Adjustment Documentation

Include MEAT in Your Risk Adjustment Documentation

Risk adjustment helps to ensure accurate and adequate payment for Medicare Advantage (MA) patient conditions, based on expected medical costs. A patient’s health status reflects the costs associated with their healthcare needs. The more of a burden the disease is, the higher the risk adjustment score is. Healthier patients have a lower risk adjustment score.

Hierarchical condition categories (HCCs) group clinically related diagnoses (ICD-10-CM codes) with similar risk adjustment cost implications. Only diagnoses that map to an HCC are used in risk adjustment score calculation.

There are more than 9,000 ICD-10 codes that map to 79 HCC codes in the risk adjustment payment model. Providers must thoroughly document all chronic disease processes and manifestations in the patient’s medical record for proper HCC coding. The progress note must include the history of present illness, physical exam, and the medical decision-making process.

One way to help ensure your documentation is up-to-par for HCC coding is to include MEAT (monitored, evaluated, assessed/addressed and treated) in the medical record for the patient encounter. To break it down, documentation must reflect:

  • MMonitoring signs, symptoms, disease progression, disease regression
  • E Evaluating test results, medication effectiveness, response to treatment
  • A Assessing/Addressing ordered tests, discussion, review records, counseling
  • TTreating medications, therapies, other modalities

Remember: A simple list of diagnoses is not acceptable or valid per official coding guidelines, as it does not meet the definition of an assessment and plan.

To learn more about risk adjustment coding and HCCs, read the article “FAQ: 10 Things You Need to Know about Risk Adjustment.” If you are interested in getting certified in risk adjustment, go to AAPC’s CRC Preparation Course webpage.

Michelle Dick
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Michelle Dick

Executive Editor at AAPC
Michelle A. Dick has been executive editor for AAPC for over 10 years. Prior to her work at AAPC, she was editor-in-chief at Eli Research and Element K Journals, and disk ad coordinator, web designer/developer, and graphic artist at White Directory Publishers, Inc. She has a Bachelor of Science in Graphic Design from the State University of New York - Buffalo State and is a member of the Flower City Professional Coders in Rochester, N.Y.
Michelle Dick
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About Has 202 Posts

Michelle A. Dick has been executive editor for AAPC for over 10 years. Prior to her work at AAPC, she was editor-in-chief at Eli Research and Element K Journals, and disk ad coordinator, web designer/developer, and graphic artist at White Directory Publishers, Inc. She has a Bachelor of Science in Graphic Design from the State University of New York - Buffalo State and is a member of the Flower City Professional Coders in Rochester, N.Y.

One Response to “Include MEAT in Your Risk Adjustment Documentation”

  1. myra jane stack says:

    This is very interesting but other than PCP/primary doctors does to have any applications to the specialty doctors? How can we as coders approach specialty visits for only 1 issue to make sure that the doctor needs to list co-morbidities that affect the outcome of the “one” reason they came in for, i.e. DM, HT, ESRD, etc, ?

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